STUDENT ENROLMENT FORM

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VIETNAMESE PARENTS & CITIZENS ASSOCIATION INC.
TRƯỜNG VIỆT NGỮ BANKSTOWN

Parents' Email Address *

Name of Community Language School *

Enrolment Year *

STUDENT'S PERSONAL DETAILS

Family Name (Họ) *

First Name (Tên) *

Second Name (Chữ Lót) *

Preferred Name (Tên ở Mainstream School) *

Gender (Phái tính) *

Male

Female

Date of Birth *

YYYY

Residential Address

Number & Street *

Suburb: *

Postcode *

Telephone Number *

Name of sibling attend this Community Language School

Class Level at Community Language School *

Mainstream School

Name of Mainstream School *

Suburb *

Class Level at Mainstream School *

Student's Medical Details

Does your child suffer from asthma? *

Yes

If Yes, Medication to be given/taken during asthma attached

Allergies: *

Medications: *

Allergies to any medications *

Medical Declaration

In the event of illness or injury to my child at school and at excursion, or travelling to or from school. I authorise the principal or senior staff member, if/where it is impossible to contact me, to consent to emergency medical treating as is necessary by a qualified medical practitioner.
Trong trường hợp con tôi đang ở trường hay đang đi tham quan, hoặc đang đi đến trường hay từ trường trở về nhà, tôi xin ủy nhiệm cho Hiệu Trưởng hoặc Giáo Viên, nếu không liên lạc được với tôi, khi cần thiết, được phép đưa con tôi đi điều trị y khoa khẩn cấp với một bác sĩ đã tốt nghiệp và có đăng ký.

Father's or Male Guardian Details

Father's or Male Guardian's name *

Relationship to student: *

Occupation

Emergency contact Number *

Mother's or Female Guardian Details

Mother's or Female Guardian's name *

Relationship to student: *

Occupation

Emergency contact Number *

Enrolment Date *

YYYY

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